Use of a triage pain protocol in the ED.

Purposes: This study was designed to evaluate the ability of a triage pain protocol to improve frequency and time to delivery of analgesia for musculoskeletal injuries in the emergency department (ED).

Basic Procedures: Frequency and time to analgesic administration were measured before and after use of a triage pain protocol. The protocol allowed analgesic medications to be given at the time of triage.

Pain in the emergency department: results of the pain and emergency medicine initiative (PEMI) multicenter study.

Unlabelled: Pain is the most common reason for emergency department (ED) use, and oligoanalgesia in this setting is known to be common. The Joint Commission on Accreditation of Healthcare Organizations has revised standards for pain management; however, the impact of these regulatory changes on ED pain management practice is unknown. This prospective, multicenter study assessed the current state of ED pain management practice.

Changing attitudes about pain and pain control in emergency medicine.

Oligoanalgesia continues to be a large problem in the ED. An attitude of suspicion, a culture of ignoring the problem, and an environment that is not conducive to change in practice combine to present formidable obstacles for effective pain management in the emergency setting. Overcoming these obstacles for effective analgesia in the ED is not beyond the capabilities of the individual ED, the emergency physician, or the specialty of emergency medicine.

Correlation of change in visual analog scale with pain relief in the ED.

Objectives: To evaluate the validity of change in visual analog Scale (VAS) as a measure of pain relief using a verbal descriptor Scale (VDS) of change in pain.

Methods: A prospective observational study of emergency department patients measured pain with VAS and recorded verbal report of change in pain.

Results: One thousand four hundred ninety patients yielded 1999 comparisons between change in VAS and VDS.

Air medical rapid sequence intubation: How can we achieve success?

Airway management is an essential component of the air medical transport of critically ill or injured patients. Many controversies surround the use of rapid sequence intubation (RSI) in the prehospital setting. The challenges of establishing an airway in this environment may exceed those in the hospital.

Comparison of etomidate and midazolam for prehospital rapid-sequence intubation.

Objective: This study compares etomidate with midazolam for prehospital rapid-sequence intubation (RSI).

Methods: The authors conducted a retrospective review of consecutive intubations at a university-based air medical program from January 1995 to December 2000. Exclusion criteria were patients not undergoing RSI, age <15 years, and incomplete chart data.

Patient expectations for pain relief in the ED.

The objective of the study was to assess patient expectations for pain relief in the ED. A convenience sample of 522 patients with pain and 144 patients without pain were enrolled in a prospective observational study at a university ED. Patients reported a mean expectation for pain relief of 72 % (95% CI 70-74).

Comparison of the intubating laryngeal mask airway versus laryngoscopy in the Bell 206-L3 EMS helicopter.

Introduction: The purpose of this study is to compare intubation success rate and time to intubation for the intubating laryngeal mask airway (I-LMA) versus direct laryngoscopy (DL) using a manikin model during a simulated in-flight scenario.

Setting: The setting for the study was a University hospital-based air medical program.

Methods: This was a prospective, randomized, crossover trial.

Patient preference for route of pain medication delivery.

We sought to determine Emergency Department (ED) patient preference for oral (p.o.), intramuscular (i.

Pain medication use before ED arrival.

The objective of this study was to determine the frequency and types of pain medications taken before ED arrival based on pain intensity, duration of pain, chief complaint, gender, age, and race. A convenience sample of patients in pain was enrolled in this university hospital-based prospective, observational study. A total of 1233 patients were enrolled.

EMS provider level does not impact use of air medical transport.

Introduction: The local emergency medical services (EMS) provider level within a nearby EMS system changed from EMT-I to paramedic. This increase in level of care was expected to decrease utilization of air medical transport and increase acuity of patients flown.

Setting: Semirural, mountainous area with an annual volume of 2800 transports.

Effect of an airway education program on prehospital intubation.

Introduction: The purpose of this study was to determine the impact of an airway education program (AEP) on prehospital intubation.

Setting: University-based air medical program

Methods: Retrospective review of 372 consecutive intubations for 3 years before and 3 years after the institution of an AEP. Descriptive statistics were used and comparisons were made using chi-square analysis.